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Langenbeck's Archives of Surgery
Published in: Langenbeck's Archives of Surgery 1/2021

01-02-2021 | Appendicitis | Original Article

Comparison of new versus reused Harmonic scalpel performance in laparoscopic appendectomy in patients with acute appendicitis—a randomized clinical trial

Authors: Jakov Mihanović, Nataša Lisica Šikić, Ivana Mrklić, Zvonimir Katušić, Robert Karlo, Miro Jukić, Ana Jerončić, Zenon Pogorelić

Published in: Langenbeck's Archives of Surgery | Issue 1/2021

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Abstract

Background

The aim of this study was to compare lateral thermal damage of the appendix and clinical outcomes after laparoscopic appendectomy using new versus reused Harmonic scalpels.

Methods

A total of 100 consecutive patients with acute appendicitis who underwent laparoscopic appendectomy were enrolled in the two-center, randomized clinical trial. Using a computer random number generator, patients were allocated to new or reused group. Histopathological measurement of lateral thermal damage of the appendiceal base and mesoappendix, speed of transection of the appendiceal base, duration of surgery, subjective rating of device functionality, length of hospital stay, and complications were compared within groups.

Results

The median lateral thermal damage on the appendiceal base in the new group (N = 49) was 0.2 mm (IQR 0.1–0.2) and 0.1 mm (IQR 0.1–0.3) in the reused group (N = 51) (P = 0.644), while on the mesoappendix for both groups, thermal damage was 0.1 mm (IQR 0.1–0.2) (P = 0.418). The median time required for base transection in both groups was 8 s (IQR 7–9) (P = 0.776). The median duration of surgery was also comparable between the groups (22 min, IQR 20–30 vs 25 min, IQR 21–35; P = 0.233). Two postoperative complications in the new group and one in the reused group were recorded (4% vs 2%; P = 0.536). Surgeons’ subjective assessment of the instrument did not reveal significant difference between the groups in all of the investigated categories.

Conclusions

The results of our study support the reuse of Harmonic scalpels especially in the settings where economic constraints might hamper access to minimally invasive surgery to a larger number of patients. The results obtained on laparoscopic appendectomy might not be reproducible to other more demanding surgical procedures.

Trial registration

ClinicalTrials.​gov registry under identifier NCT04226482
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Metadata
Title
Comparison of new versus reused Harmonic scalpel performance in laparoscopic appendectomy in patients with acute appendicitis—a randomized clinical trial
Authors
Jakov Mihanović
Nataša Lisica Šikić
Ivana Mrklić
Zvonimir Katušić
Robert Karlo
Miro Jukić
Ana Jerončić
Zenon Pogorelić
Publication date
01-02-2021
Publisher
Springer Berlin Heidelberg
Published in
Langenbeck's Archives of Surgery / Issue 1/2021
Print ISSN: 1435-2443
Electronic ISSN: 1435-2451
DOI
https://doi.org/10.1007/s00423-020-02039-y

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